How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | None | $83.18 | $83.18 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $1,479.11 | Facility | None | $109.65 | $199.53 | $1,479.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $416.87 Typical High $912.01 | Professional | None | $72.44 | $416.87 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $61.66 Median $165.96 Typical High $218.78 | Professional | None | $61.66 | $165.96 | $218.78 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $1,479.11 | Facility | None | $109.65 | $199.53 | $1,479.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $416.87 Typical High $912.01 | Professional | None | $72.44 | $416.87 | $912.01 |
United Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $165.96 | Professional | None | $61.66 | $93.33 | $165.96 |
Well Sense Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $933.25 | Facility | None | $467.74 | $630.96 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.91 |
Where Massachusetts sits
The same service costs 4.9 times more in North Dakota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 9th of 51
$145
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.